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Indoor air exposure to coal and wood combustion emissions associated with a high lung cancer rate in Xuan Wei, China
Prevention Declining lung cancer rates among young men and women in the United States: A cohort analysis Devesa SS, Blot WJ, Fraumeni JF Jr. Division of Cancer Etiology, Nnfionnl Cancer Institule, Bethesda. MD 20892. J Natl Cancer Inst 1989;81:1568-71. Although overall age-adjusted rates of mortality from lung cancer in tbe United States continue to rise, rates at ages below 45 years have begun to decline. In this report we’show that the decrease is greatest among white men, with a 29% drop between the mid-1970s and mid1980s. but a decrease also occurred among black men and white and black women. Cohort analyses revealed that the rates of lung cancer peaked among men born around 1925.1930 and among women born around 1935-1940, and have declined thereafter. If these trends continue, overall lung cancer mortality rates will start to decline in the 1990s among men and after the year 2000 among women. Dietary factors and risk of lung cancer: Results from a case-control study, Toronto, 1981-1985 lain M, Burch JD, Howe GR,Risch HA, Miller AB. NCICEpidemi&y Unit, McMurrich Building, Universi?v of Toronto, 12 Queen’s Park Crescent West. Toronto. Ont. M5S lA8. Int J Cancer 1990;45:287-93.
Associations between dietary factors and risk of lung cancer are reported from a study of 839 cases and 772 population-based controls interviewed in metropolitan Toronto between 1981 and 1985. Increased consumption of vegetables is associated with a decreased relative risk of 0.60 (95% confidence limits = 0.40 to 0.88) for those in the highest compared with the lowest quartile. Cholesterol intake is associated with increased risk, but this is restricted to those in the highest quartile for whom the relative risk is 1.58 (95% confidence limits = 1.05 to 2.38) compared with those in the lowest quartile. The results of this study suggest that dietary factors may affect the risk of lung cancer, but identification of the specific constituents involved will require further research. Screening for lung cancer in the middle-aged Bemdt R, Nischan P, Ebeling K. Clinic for Oncology, Departmenr of Medicine (Churite). Humboldt University, Schumanns~rasse 20-21. DDR-1040 Berlin. Int J Cancer 1990;45:229-30. A screening programme for lung diseases has been in operation in the German Democratic Republic for more than 3 decades. The programme is based on biennial chest X-rays (70 x 70 mm posterior-anterior) of the population 40 years of age or over. With respect to lung cancer the results show that, for the population under 60 years of age, the adjusted relative risk of dying from lung cancer among subjects who took partin the last screening round compared with subjects who did not but were screened at least once during the preceding IO-year period was 0.93 (95% confidence interval 0.65-1.33). Smoking, air pollution, and the high rates of lung cancer in Shenyang, China XuZ-Y,BlotWJ,XiaoH-Petal.Div~slonofCancerE~io~ogy, National CancerInstitrue, Bethesda, MD. J Nat1 Cancer Inst 1989;81:18oQ-6. A case-control study involving interviews with 1,249 patients with lung cancer and 1,345 population-based controls was conducted in Shenyang, an industrial city in northeastern China, where mortality rates are high among men and women. Cigarette smoking was found to be the principal cause of lung cancer in this population, accounting for 55% of the lung cancers in males and 37% in females. The attributable risk percentage among females is high compared to elsewhere in China, largely because of higher prevalence of smoking among women. After adjustment for smoking, there were also significant increases in lung cancer risk associated with several measures of exposure to air pollutants. Risks were twice as high among those who reported smoky outdoor environments, and increased in proportion to years of sleeping
on beds heated by coal-burning stoves (kang), and to an overall index of indoor air pollution. Threefold increases in lung cancer risk were found among men who worked in the nonferrous smelting industry, where heavy exposures to inorganic arsenic have been reported. The associations with both smoking and indoor air pollution were stronger for squamous cell and small cell carcinomas than for adenocarcinoma of the lung. Risks due to smoking or air pollution were not altered by adjustment for consumption of fresh vegetables or sources of beta carotene or retinal, prior chronic lung diseases, or education level. The findings suggest that smoking and environmental pollution combine to account for the elevated rates of lung cancer mortality in Shenyang.
Epidemiology
and etiology
Assessing indoor air pollution exposure and lung cancer risk in Xuan Wei, China ChapmanRS,MumfordJL,HeX,HarrisDB.YangR. Jiang W. Human Studies Division, Health Effects Research Laboratory, Environmenlal Protection Agency, Research Triangle Park. NC 27711. J Am Coll
Toxic01 1989;8:941-8. This report presents the risk-assessment-related aspects of a multidisciplinary study of indoor coal smoke pollution and lung cancer in Xuan Wei County, Yunnan Province, China. Xuan Wei presents a unique natural experiment in environmental carcinogenesis because lung cancer mortality rates and indoor pollution exposures vary widely within the County. Current evidence links lung cancer with domestic burning of ‘smoky coal’, as opposed to ‘smokeless coal’ and wood. Efforts to determine the most carcinogenic components of smoky coal pollution are in progress, as are efforts to develop a quantitative relationship of pollution dose with lung cancer response in Xuan Wei. Seine available evidence suggests that the composition of indoor pollution does not vary greatly throughout Xuan Wei, and thus that lung cancer risk is a function of overall pollution exposure. Other evidenci suggests that different Xuan Wei fuels exhibit different carcinogenic potencies. Onsite and laboratory studies are being conducted to differentiate between these possibilities.
ated with a high lung cancer rate in Xuan Wei, China Mumford JL, Chapman RS, Harris DB et al. U.S. Environmental Proteclion Agency, Research Triangle Park. NC 27711. Environ Int 1989;15:315-20. Residents of Xuan Wei County in%hina have unusuallp high lung cancermonalitythatcannotbeatuibu~totobaccouseoroccupational exposure. They are exposed to smoke from unvented, open pit coal or wood fires (often used for cooking and heating). The variation in lung cancer rates among communes within the county suggests that indoor combustion of smoky coal may be the prime determinant of Iling cancer. To characterize the air in Xuan Wei homes, samples of air particles and semivolatile organic compounds were collected from homes located in two communes; one commune has a high tad of lung cancer, and the other has a low rate. Samples collected in the commune tihere the lung cancer rate is high and where smoky coal is the predominant fuel contained high concentrations of small particles with high organic content; organic extracts of these samples were mutagenic. Sam$ea from homes in the wood-burning commune, which hasa lowrateoflung cancer,consisledmosUyoflargerpaniclesoflowerorg~icconlentand mutagenicity. The smoky coal sample was a mouse skin carcinogen and’ was a more potent initiator of skin tumors in comptiison to the wood or smokeless coal sample. Mechanisms of smoking-induced Idell S, Garcia JGN. Deparment Health
lung injury of Medicine.
University of Tern
Center al Tyler, Tyler, 7X 75710. Semin Re~pi Med l989;lO:gS-
55. A considerable body of evidence has been and continues to be
Associations between dietary factors and risk of lung cancer are reported from a study of 839 cases and 772 population-based controls interviewed in metropolitan Toronto between 1981 and 1985. Increased consumption of vegetables is associated with a decreased relative risk of 0.60 (95% confidence limits = 0.40 to 0.88) for those in the highest compared with the lowest quartile. Cholesterol intake is associated with increased risk, but this is restricted to those in the highest quartile for whom the relative risk is 1.58 (95% confidence limits = 1.05 to 2.38) compared with those in the lowest quartile. The results of this study suggest that dietary factors may affect the risk of lung cancer, but identification of the specific constituents involved will require further research. Screening for lung cancer in the middle-aged Bemdt R, Nischan P, Ebeling K. Clinic for Oncology, Departmenr of Medicine (Churite). Humboldt University, Schumanns~rasse 20-21. DDR-1040 Berlin. Int J Cancer 1990;45:229-30. A screening programme for lung diseases has been in operation in the German Democratic Republic for more than 3 decades. The programme is based on biennial chest X-rays (70 x 70 mm posterior-anterior) of the population 40 years of age or over. With respect to lung cancer the results show that, for the population under 60 years of age, the adjusted relative risk of dying from lung cancer among subjects who took partin the last screening round compared with subjects who did not but were screened at least once during the preceding IO-year period was 0.93 (95% confidence interval 0.65-1.33). Smoking, air pollution, and the high rates of lung cancer in Shenyang, China XuZ-Y,BlotWJ,XiaoH-Petal.Div~slonofCancerE~io~ogy, National CancerInstitrue, Bethesda, MD. J Nat1 Cancer Inst 1989;81:18oQ-6. A case-control study involving interviews with 1,249 patients with lung cancer and 1,345 population-based controls was conducted in Shenyang, an industrial city in northeastern China, where mortality rates are high among men and women. Cigarette smoking was found to be the principal cause of lung cancer in this population, accounting for 55% of the lung cancers in males and 37% in females. The attributable risk percentage among females is high compared to elsewhere in China, largely because of higher prevalence of smoking among women. After adjustment for smoking, there were also significant increases in lung cancer risk associated with several measures of exposure to air pollutants. Risks were twice as high among those who reported smoky outdoor environments, and increased in proportion to years of sleeping
on beds heated by coal-burning stoves (kang), and to an overall index of indoor air pollution. Threefold increases in lung cancer risk were found among men who worked in the nonferrous smelting industry, where heavy exposures to inorganic arsenic have been reported. The associations with both smoking and indoor air pollution were stronger for squamous cell and small cell carcinomas than for adenocarcinoma of the lung. Risks due to smoking or air pollution were not altered by adjustment for consumption of fresh vegetables or sources of beta carotene or retinal, prior chronic lung diseases, or education level. The findings suggest that smoking and environmental pollution combine to account for the elevated rates of lung cancer mortality in Shenyang.
Epidemiology
and etiology
Assessing indoor air pollution exposure and lung cancer risk in Xuan Wei, China ChapmanRS,MumfordJL,HeX,HarrisDB.YangR. Jiang W. Human Studies Division, Health Effects Research Laboratory, Environmenlal Protection Agency, Research Triangle Park. NC 27711. J Am Coll
Toxic01 1989;8:941-8. This report presents the risk-assessment-related aspects of a multidisciplinary study of indoor coal smoke pollution and lung cancer in Xuan Wei County, Yunnan Province, China. Xuan Wei presents a unique natural experiment in environmental carcinogenesis because lung cancer mortality rates and indoor pollution exposures vary widely within the County. Current evidence links lung cancer with domestic burning of ‘smoky coal’, as opposed to ‘smokeless coal’ and wood. Efforts to determine the most carcinogenic components of smoky coal pollution are in progress, as are efforts to develop a quantitative relationship of pollution dose with lung cancer response in Xuan Wei. Seine available evidence suggests that the composition of indoor pollution does not vary greatly throughout Xuan Wei, and thus that lung cancer risk is a function of overall pollution exposure. Other evidenci suggests that different Xuan Wei fuels exhibit different carcinogenic potencies. Onsite and laboratory studies are being conducted to differentiate between these possibilities.
ated with a high lung cancer rate in Xuan Wei, China Mumford JL, Chapman RS, Harris DB et al. U.S. Environmental Proteclion Agency, Research Triangle Park. NC 27711. Environ Int 1989;15:315-20. Residents of Xuan Wei County in%hina have unusuallp high lung cancermonalitythatcannotbeatuibu~totobaccouseoroccupational exposure. They are exposed to smoke from unvented, open pit coal or wood fires (often used for cooking and heating). The variation in lung cancer rates among communes within the county suggests that indoor combustion of smoky coal may be the prime determinant of Iling cancer. To characterize the air in Xuan Wei homes, samples of air particles and semivolatile organic compounds were collected from homes located in two communes; one commune has a high tad of lung cancer, and the other has a low rate. Samples collected in the commune tihere the lung cancer rate is high and where smoky coal is the predominant fuel contained high concentrations of small particles with high organic content; organic extracts of these samples were mutagenic. Sam$ea from homes in the wood-burning commune, which hasa lowrateoflung cancer,consisledmosUyoflargerpaniclesoflowerorg~icconlentand mutagenicity. The smoky coal sample was a mouse skin carcinogen and’ was a more potent initiator of skin tumors in comptiison to the wood or smokeless coal sample. Mechanisms of smoking-induced Idell S, Garcia JGN. Deparment Health
lung injury of Medicine.
University of Tern
Center al Tyler, Tyler, 7X 75710. Semin Re~pi Med l989;lO:gS-
55. A considerable body of evidence has been and continues to be